http://www.bjj.boneandjoint.org.uk/content/95-B/11_Supple_A/140.abstract
Femoral and tibial component rotation in total knee arthroplasty
methods and consequences
- R. D. Scott, MD, Professor of Orthopaedic Surgery 1
+Author Affiliations
- Correspondence should be sent to Dr R. D. Scott; e-mail:rdscottmd@gmail.com
Abstract
At least four ways have been described to determine femoral component rotation, and three ways to determine tibial component rotation in total knee replacement (TKR). Each method has its advocates and each has an influence on knee kinematics and the ultimate short and long term success of TKR. Of the four femoral component methods, the author prefers rotating the femoral component in flexion to that amount that establishes a stable symmetrical flexion gap. This judgement is made after the soft tissues of the knee have been balanced in extension.
Of the three tibial component methods, the author prefers rotating the tibial component into congruency with the established femoral component rotation with the knee is in extension. This yields a rotationally congruent articulation during weight-bearing and should minimise the torsional forces being transferred through a conforming tibial insert, which could lead to wear to the underside of the tibial polyethylene. Rotating platform components will compensate for any mal-rotation, but can still lead to pain if excessive tibial insert rotation causes soft-tissue impingement.
Cite this article: Bone Joint J 2013;95-B, Supple A:140–3.
Footnotes
- No benefits in any form have been received or will be received from a commercial party related directly or indirectly to the subject of this article.This paper is based on a study which was presented at the 29th Annual Winter 2012 Current Concepts in Joint Replacement® meeting held in Orlando, Florida, 12th – 15th December.
- Received August 20, 2013.
- Accepted August 21, 2013.
- ©2013 The British Editorial Society of Bone & Joint Surgery
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